# Controlling Severe Bleeding

Uncontrolled bleeding kills faster than almost anything else you can treat in
the field. Minutes matter.

## Direct pressure first

Press hard, directly on the wound, with whatever clean material you have. Do not
lift the dressing to check — that breaks the clot you just formed. Add layers on
top instead.

## Tourniquets

If direct pressure does not control arterial bleeding from a limb, apply a
tourniquet. Place it **2 to 3 inches above the wound**, never directly over a
joint. Tighten until the bleeding stops, which will hurt.

**Write the time of application** on the tourniquet or on the patient's
forehead. This single piece of information drives every decision made downstream
of you.

Do not loosen or remove a tourniquet once it is applied. That is a decision for
someone with surgical capability.

## Wound packing

For a deep wound in a junctional area where a tourniquet cannot be placed — the
groin, the armpit, the neck — pack the wound tightly with gauze and hold firm
pressure for a full **3 minutes** before reassessing.